HSSM72
Social Determinants of Global Health and Health Systems
Student name
Student ID
Social Determinants of Global Health and Health Systems, New Zealand
New Zealand is known as the island nation, which is situated in the South Pacific Ocean east of Australia. It consists of various smaller islands and two major islands named South Island and North Island that are separated by the Cook Strait. In terms of size, New Zealand ranks 76th in the world, ranking based on the surface area of 103,483 square miles. There are various languages that are used in New Zealand, including English, French, Northern Chinese, Hindi, Yue, and New Zealand Sign Language (Worldpopulationreview.com, 2022). The estimated population of New Zealand at the end of 2021 was around 5,127,200, of which 2,544,600 are the estimated population of males and 2,582,600 females (Govt.nz, 2022). Further, based on the study, it has been found that the GDP of New Zealand in 2021 was 5.6% which is an annual growth rate (Govt.nz, 2022).
New Zealand’s healthcare system is restructuring and changing at a continuous pace. It has been found that in recent decades the country has faced various system-wide changes in which the most recent changes have become evolutionary and incremental. Based on the study, it has been found that the primary funder of New Zealand’s healthcare system is the central government which directly distributes tax funds to the public institution through the Ministry of Health, in which 20 District Health Boards (DHB) are funded by the Ministry (Gauld, 2016). In addition to this, universal health coverage has been achieved in New Zealand, which was mostly achieved by public funds. Which DHB is responsible for planning, providing and purchasing the health services for the local level. However, on some services, co-payments are owed by the patients in New Zealand for some products and services. Approx. One-third of the population of New Zealand is covered with private insurance for paying the co-payments and non-covered services (Gauld, 2020). Further New Zealand government also sets benefit packages and annual budgets for the healthcare system.
One of the curious features of the healthcare system of New Zealand is out of pocket spending, which has become a major part of its healthcare system. In 2015 the total out of pocket spending that was accounted for was approx. 12.6% includes both costs paid by private households and cost-sharing. However, it has been found that in New Zealand’s healthcare system, there are no deductibles, although, for General Practitioner (GP) services, co-payments are required, and in GP clinics, various nursing services are provided (Gauld, 2020). At the same another feature that can describe New Zealand’s healthcare system is inequalities. It has been suggested that there have been inequalities in health between the non-Maori and Maori (New Zealand’s Indigenous Polynesian people) populations that can be explained by the four major factors. These major factors are lifestyle factors, socioeconomic factors, discrimination, and access to health care. New Zealand Health survey suggests that one of the major determinants of health is the self-reported experience of racial discrimination and racism (Eriksson and Eriksson, 2017). Further socioeconomic differentials are considered as one of the fundamental explanations for the inequalities that are observed in health status between predominant groups and minorities. The racial classification of the non-Maori and Maori is one of the major features of the healthcare system of New Zealand that impacts professional practices and government policies. For addressing this, the government have included separate health care practices and policies (Rata and Zubaran, 2016). Whanau Ora policy is one of the major government social and health initiatives.
The covid scenario placed a significant impact on the different aspects of the healthcare infrastructure. However, the increased covid infection caused a simultaneous negative impact both on the public and private health care system. The combined functioning of privatisation with the public health care system significantly resulted in reduced waiting time, better interaction, and effective caregiving to patients. Nonetheless, the privatisation functioning of the care system has also delivered the disadvantages of lowered diagnostics accuracy, low staff level, and increased finances of activities (Assa and Calderon, 2020). The observation of the covid scenario in New Zealand also significantly displayed similar outcomes as recorded at the global level. The monitoring highlighted New Zealand majorly being based on the public health care system effectively resulting in reliable handling of the pandemic situation. The public system contributed through appropriate tacking and diagnosing of the individuals. However, the privatisation along with the public system in New Zealand resulted in enhanced vaccination of the individuals with better testing, emergency, and health care services. In addition, the system also resulted in confusion reduction among people with better management of the virus spread (Assa and Calderon, 2020). Although, the issue related to limited resources availability and service delivery also raised significantly in the health care system, which affected the situation.
The covid situation effectively highlighted the importance of healthcare and management leadership in society. Different countries and their leadership used their respective styles of thinking the handling the covid situation. The various countries and leaders are involved in their respective decision-making and responses to handle the situation. Similarly, the New Zealand leaders also utilised their leadership skills and capabilities for handling the covid spread and death rate among their people. The decisive actions supported leaders to take creative and reliable measures for controlling the pandemic. The early restriction on travelling with self-isolation effectively highlighted the appropriate leaders’ qualities were displayed by the country leaders (Jefferies et al., 2020). Further, the intention of “go hard and go early” and guide to handle covid scenario effectively showed the positive side of the New Zealand health care leadership policies (Wilson, 2020). The New Zealand leaders were also being praised for the decisive action they took to handle the covid situation (Al Saidi et al., 2020). The appropriate coordination among different government departments with health dimensions is supported for identifying the problem and providing the solution causing reliable managing of covid health care management performance.
Non-communicable diseases (NCDs) kills more than 40 million people each year, and it is approximately 72% of the total death that occurs in a year from the disease. The disease that includes in the NCDs are obesity, cardiometabolic diseases, arthritis, cancers, cardiovascular disease and diabetes etc., and the consequences of these diseases are long terms which can affect the lifestyle of the person (Phillips et al., 2019). Diabetes is one of the most common non-communicable diseases, and it is one of the global epidemics because 1 out of 11 adults in the world has been diagnosed with diabetes (Gounder and Ameer, 2017). Diabetes occurs in the person when the pancreas present in the human body does not produce the required amount of insulin that is required to prevent and maintain the sugar produced in the human body. According to Gounder and Ameer (2017), there are mainly two types of diabetes that are type 1 and type 2, and in total, more than 400 million people all over the world have been diagnosed with either type 1 or type 2 diabetes. People that are diagnosed with diabetes are going to increase, and it can move to almost 600 million by the year 2040 (Petrie et al., 2018). This increase in the number has made diabetes an epidemic disease all over the world.
According to Diabetes New Zealand (2021), in New Zealand, the number of patients that are diagnosed with type 2 diabetes will increase by approximately 90 % in the next 20 years. As the number of patients with diabetes increases, the social and economic costs of the patients diagnosed with diabetes are almost increased by 60 per cent in New Zealand. It could increase more if the government of New Zealand did not take proper actions. For the management of diabetes government of New Zealand have to take different action which can not only enhance the working capability of the New Zealand health care system but also reduce the death rate. According to Chepulis et al. (2021), for the management of diabetes, it is important to manage the barriers that occur in the management of diabetes in New Zealand. The barriers that occur with the treatment of diabetes are mainly financial and social, which can create a lot of other problems. In addition, according to Daly et al. (2020), there are different reports that show the occurrence of foot diseases in the people that suffer from diabetes in New Zealand. This is the reason that the government of New Zealand have been developing different methods which not only help in preventing diabetes but at the same time it also prevents the occurrence of any other side effects like foot disease in the people.
According to Diabetes New Zealand (2021) government of New Zealand is aware of the increase in the cost of managing diabetes by including four intervention techniques that are as follows: Initiations of a program called the health people and healthy lives intervention: It is a lifestyle program that has been used to prevent the progress of prediabetes. Availability of better medication in all over New Zealand for the treatment of diabetes. The government of New Zealand have also tied up with different universities in Otago to research non-communicable disease so that treatment methods can be developed easily and enhance the quality of services. According to Govt. NZ (2016) the program Healthier lives began in the year 2016 and raised funds to reduce the health care burden on the people of New Zealand. In this program, the University of Otago has been conducting research to develop different methods that can help tackle diseases like cancer, obesity and diabetes etc. This program is funded by the ministry of business, innovation and employment. The government have also developed different methods that can be helpful in managing the side effects of diabetes by developing a foot screening method.
At the end of the year 2019, a respiratory disease occurred in Wuhan city, China, that widespread at a very fast speed all over China. This disease was declared a world pandemic by the WHO at the start of January 2020. This disease is highly transmittable among humans through a small distance (Yuki et al., 2020). Rume and Islam (2020) mentioned in their research paper that COVID-19 is a communicable disease, and the mode through which the virus is widespread is through the nose and mouth. COVID-19 creates a huge impact on the lifestyle of human beings along with the economy of the country. The virus of COVID-19 was spreading around the world, and one of the main reasons is the tourism industry (Roman et al., 2020). After the declaration of COVID-19 as a world pandemic, the governments of every country suddenly imposed a lockdown to minimise tourism activities and protect their country from the COVID-19 disease. During the time of COVID-19, lockdown is one of the major implementations by the side of government to reduce its impact on the citizens of their country.
The management of the covid-19 pandemic have varied differently in the nations, and different nations have developed different methods and mitigation technique to prevent the spreading of covid-19. According to Summers et al. (2020), the response of New Zealand's initial response to covid-19 is similar to the plan that was developed during the influenza virus in the year 2017. New Zealand has followed a simple strategy which includes the reduction of curve and delay in the peak of covid-19. The government of New Zealand have imposed restrictions on travelling and imposed the requirement of quarantine were imposed for travellers, especially for those who are travelling from the hotspot of covid-19. During the lockdown, the government of New Zealand have started a training program but did not have any specialised training program at ground level. In addition, as per Baker et al. (2020), the methods based on which New Zealand have imposed lockdown is by dividing them into the category of different Alert. New Zealand has improved their tracking system, which helps in enhancing the tracking of patients by using the number that has been allotted to every citizen of New Zealand. Chan et al. (2020) discussed the condition of New Zealand during the time of lockdown. They discuss that during the time of COVID-19, it was reported that the healthcare system in New Zealand hospitalised people that have the symptoms of acute coronary syndromes (ACS). Altman (2020) also explained that to protect the citizens, the government of New Zealand implies some policies throughout the nation. The major implications made by the government are the introduction of the lockdown, compulsion of the face masks, and the use of hand sanitisers before and after doing any work. Fouda et al. (2020) also discussed that the government of New Zealand implements some health policies for the citizens. These policies are used to maintain the economic condition of the country and also use 9.3% of GDP as the health expenditure for the citizens.
According to Cousins (2020), it has been recorded that in New Zealand there are more than 1.5 lakh people were tested positive for the COVID-19 virus. They also discussed that the prime minister of New Zealand, Jacinda Ardern implies strict lockdown throughout the country as an elimination policy of COVID-19. The government implied the lockdown when they recorded 102 COVID cases and 0 deaths in the country. This implication of lockdown impacts positively on the country, and they won an international praise award by the WHO for this policy. In addition, Zaman et al. (2020) also described that the main role in the elimination of COVID-19 from New Zealand is of the healthcare workers and the government, along with the citizens of New Zealand praise their healthcare workers and hospital staff members for their extraordinary job by putting their lives in danger. This management of covid-19 has helped New Zealand, and the detection of low cases and prevent communal spread have increased the mortality rate in New Zealand to around 4 in a million.
Communicable and Non-Communicable diseases are diseases that can harm the body and reduce the health of the person. The management of these diseases is important and different countries have developed different methods and techniques to manage both communicable and non-communicable diseases. New Zealand is one of those countries that have developed effective methods and strategies to manage communicable diseases like covid and non-communicable diseases like diabetes. New Zealand government have developed strategies and methods that can be crucial in fighting covid-19 effectively and also develop methods to improve the efficiency of people against non-communicable diseases.
References
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